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2 OBJECTIVES: At the end of this presentation, the participant will be able to:Describe the roles of the organizations associated with nephrology nursing certificationExplain the differences between licensure and certificationList at least 3 reasons to obtain specialty certificationBriefly describe the process of exam development

3 What is the Nephrology Nursing Certification Commission (NNCC)?Established in 1987 for the purpose of developing a professional certification program for nephrology nursesFormerly the Nephrology Nursing Certification Board (NNCB)A separately incorporated, independent professional nursing organizationComprised of 8 Commissioners who are either CNN certified or CNN-NP certified; and one public memberThe public member cannot be a nurse or other healthcare professional

5 What is a professional membership organization?An organization of members for whom educational and professional offerings and events are provided.Examples are the American Nephrology Nurses Association (ANNA) and the National Association of Nephrology Technicians/Technologists (NANT).They promote professional growth.They provide approved continuing education.They promote, recognize, and/or endorse certification.They do NOT administer certification examinations.

6 What does the American Nephrology Nurses’ Association (ANNA) have to do with certification?ANNA maintains that certification is an essential component of specialty nursing practice and that it must be designed to protect the public from unsafe & incompetent caregivers.ANNA recognizes & endorses certification credentials where practice analyses and the credentialing body undergo an external peer review process.ANNA encourages certification for all levels of nephrology nursing practice.

7 Both NNCC and ANNA are independent organizations and are separately incorporated.This point is very important. Many people think that we are the same organization.

8 ANNA and NNCC are NOT the same: They are different!Certification organization that promotes patient safety and quality of careCertification of nephrology caregiversResearch and test development to ensure national relevance and reflection of current practice and roles in nephrologyMembership organization that promotes professional development and educationProvides educational resources to support certificationAdvocates for the value of certificationThis slide reiterates the separate missions of the two organizations.

9 What does the American Board of Nursing Specialties (ABNS) say about this relationship?“A certifying organization (e.g., NNCC) is required to have organizational autonomy but can have a collaborative relationship with a national specialty association (e.g., ANNA, NANT) that supports the specialty and the standards of practice for the specialty.”Many professional organizations enjoy a collaborative relationship with their certifying organization.

10 What is the American Board of Nursing Specialties (ABNS)?ABNS is a not-for-profit, membership organization that focuses on improving patient outcomes & consumer protection by promoting specialty nursing certification.The vision of ABNS is that specialty nursing certification is THE standard by which the public recognizes quality nursing care.ABNS promotes the value of certification to all stakeholders.

11 What about the Accreditation Board for Specialty Nursing Certification (ABSNC)?ABSNC is the only accrediting body specifically for nursing certificationABSNC accreditation is a peer-review mechanism that allows organizations, such as NNCC, to obtain accreditation of their certification programs by demonstrating compliance with the highest quality standards available in the industry.

12 ABSNC (cont.)Individuals who pass exams that have been submitted and met the Accreditation Standards of ABSNC are said to be “Board Certified”.Currently the CDN & CNN exams are accredited by ABSNC so these certificants can say they are “Board Certified”.Our CNN and CDN exams are accredited. We are in the process of accrediting our other exams.

13 What is the Center for Nursing Education & Testing (C-NET)?Meeting Nursing’s Assessment NeedsC-NET provides a full range of test development and test administration services, including:Certification testing for specialty nursing practicePreadmission testing for RN and LPN/LVN schools of nursingClinical Judgment Series of tests for nursing practice settingsTest construction workshops for nurse educatorsC-NET works with the NNCC to ensure that all of the exams offered are reliable and valid and meet industry standards.Reliability and validity will be explained in more detail later.

14 Licensure – Certification ... What are the Differences?All graduate nurses must pass the National Council Licensure Examination (NCLEX) to become licensedLicensure validates the entry level competence of basic nursing knowledge & skillAn agency of the state government (e.g., state board of nursing) grants permission to these individuals to engage in the practice of nursing as defined by the state nurse practice act; provides the legal authority to practice nursingLicensure is required to practice nursing. Specialty certification is voluntary.

15 Licensure (cont.)Permits the use of a particular title and defines the scope of practiceOthers are prohibited from practicing the profession

16 Certification:Defined by ABNS as “the formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes.”Certification validates advanced knowledge and competence in a specialtyUsually a voluntary process for nurses by which a nongovernmental agency grants recognition to an individual who meets predetermined qualifications (i.e., experience, approved CNE, testing, etc.)

17 Certification (cont.)A requirement by the Centers for Medicare and Medicaid Services (CMS) for dialysis technicians since 2008The purpose of certification is to protect the public; it allows consumers of health care to easily identify competent caregivers

18 What is the Purpose of Certification Exams?These exams evaluate the extent to which patient care providers have attained the knowledge & skills necessary for competent practice within an identified role in a particular specialty.Certification indicates a higher degree of professional competence than the minimal requirement for licensure.Patient care providers combine elements of basic nursing knowledge with knowledge in the specialty to deliver care to patients.The certification exam is designed to measure the attainment of that knowledge at a defined level of competence.

19 What Are the Keystones of Exam Development?The domains of practiceStandards and Scope of Practice - ANNACore Curriculum for Nephrology Nursing - ANNACore Curriculum for Dialysis Technicians - MEI/AmgenExpert nephrology practitioners from across the countryCMS regulations and interpretive guidance 2008Validity“Are we testing what we think we’re testing?”“Does the test reflect current practice throughout the US?”On-going test validation through practice analysesReliabilityConsistency of the test in measuring the candidate’s ability levelStatistical evaluations of test performanceAll of these components are required to ensure that we are up to date and accurate with current practice and testing.

20 What is a Practice Analysis/Role Delineation Survey?The activities involved in a practice analysis ensure the exams reflect current practice within defined roles.Panels of national nephrology experts meet to identify domains of practice for each exam.Panels develop lists of activities that make up the practice of nephrology caregivers.National surveys of nephrology nurses and/or technicians are conducted to determine the frequency and importance of each activity.

21 Practice analysis (cont.)Survey results are analyzed and used to develop an outline of the domains of practice (i.e., the major topics) to be addressed in each exam.Specifics of the analysis are put together to create a “blueprint” for each exam.Each test question is linked directly to the national survey results.A practice analysis/role delineation study is conducted at least every five years for each exam.Practice surveys are required periodically to update our blueprint or guide for test development.

22 What Should I Know About Test Questions?Test questions require the examinee to analyze and apply information in practice situations, not simply recall facts.All test questions are supported by current published references.All newly written questions are pilot tested before they are scored.

23 Test questions (cont.)Panels of expert nephrology nurses and/or technicians use an established standard process to set the passing score for each exam.All test questions are reviewed and revalidated at least every three years.Challenges to the development of a good test question:Practice variations based on geographic locationVariances in practice among providersFrequent changes in nephrology practice and rolesFederal and state regulationsThis review is extensive. Care is taken to ensure that there are resources to support each question.

24 Why should I become Certified?To help ensure patient safetyTo meet the challenge of providing patient care in a more complex environment including:Advances in technologyOlder patients with more co-morbiditiesCulturally diverse patient populationsMore complex government regulations & reimbursement issues

25 What’s In It For Me? Self confidence in decision makingEnhanced professional credibilityLeadershipCompetenceInitiativeUp-to-date knowledge baseValidation of skillsInspiration to strive for excellenceThese reasons are the ones most often cited by nurses who are certified.

26 How does my certification benefit the profession?Demonstrated commitment to qualityValidation of professional achievementMore confident decision-makingHigh degree of accountabilityCommitment to life long learningQualification for Magnet Status

28 What are some barriers to certification?FinancialCost of the examinationLack of institutional rewardLack of institutional supportTime CommitmentInadequate supervisory supportTest anxietyContinuing education requirements

29 You CAN break down those barriers!Hold a certification examination review courseEncourage financial incentivesMerit pay increaseFree continuing education opportunitiesIncrease recognition of certified staffAnnouncing certification successes at staff meetingsPosting lists of certified caregivers in the workplace with photos of newly certified staffPromoting facility funded attendance at regional or national educational meetingsWorking to establish a work place program to encourage certification at your facility